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Gender Bias in Knee Osteoarthritis

Gender Bias in Knee Osteoarthritis

According to epidemiologic data, there appear to be biologically derived and behaviorally influenced disparities in knee osteoarthritis (OA) and treatment with total knee arthroplasty (TKA). Specifically, the burden of disease is significantly higher for women. Women tend to develop knee OA more frequently than men and present with more advanced disease at the time of TKA. “Factors such as weight and activity levels are likely part of the reason for these trends,” says Mary I. O’Connor, MD. “Furthermore, studies are showing that women are typically more obese than men. There may also be sex-based differences in vitamin D receptors, inflammatory markers, or cartilage make-up.” Unconscious Gender Bias According to Dr. O’Connor, healthcare providers may be unconsciously biased based on gender. “Patients and providers need to become aware of this potential bias,” she says. “Clinicians should be aware that they could have a bias and make conscious efforts to treat patients equally.” She adds that patients will often pick up on non-verbal clues in providers with unconscious biases. Physicians should be cognizant of the profound influence they have on the decisions patients make. In a recent Canadian study of standardized patients with moderate knee OA, orthopedic surgeons were much more likely to recommend surgery to men than to woman. Specifically, 42% of orthopedic surgeons recommended TKA to male patients but not female patients, whereas 8% recommended TKA to females but not to males. “More research is needed to further study potential disparities in treatment recommendations,” notes Dr. O’Connor. “By studying sex differences, we may be able to target therapies more effectively.” In addition, Dr. O’Connor believes that further research is...
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